The association of blood urea nitrogen levels with mortality in acute pulmonary embolism


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Abstract

Background:The aim of this study was to investigate the association of BUN levels with in-hospital and long-term adverse clinical outcomes in acute pulmonary embolism (APE) patients treated with tissue-plasminogen activator (t-PA).Methods:This retrospective study included 252 consecutive confirmed APE patients treated with t-PA. An admission BUN of 34.5 mg/dL was identified through an ROC analysis as an optimal cutoff value to predict the in-hospital mortality with 85% sensitivity and 91% specificity (AUC: 0.91; 95% CI: 0.84–0.96; P < .001).Results:Our study showed that an increase in BUN levels was independently associated with a high risk of in-hospital all-cause mortality, low admission systolic blood pressure, use of inotropic drugs, and cardiogenic shock. In-hospital mortality rates were 51.1% in higher BUN group, and 1.9% in lower BUN group (P < .001).Conclusion:In this study, elevated admission BUN level was found to be a predictor of all-cause in-hospital mortality. BUN testing is commonly part of the basic metabolic panel; and it can be used to detect high-risk patients with APE, and it bears little risk, is inexpensive, and easy to perform.HighlightsThis relationship has not yet been investigated.This study is also the first to demonstrate that elevated admission BUN level is a strong predictor of in-hospital all-cause mortality in APE patients treated with t-PA.Thereby, this study may be attractive for most cardiologists and pulmonologist.Moreover, our study consists of unique patient population, which only included patients with APE treated with t-PA.As a result, APE is still the most common preventable cause of hospital-related death worldwide. Therefore, several risk charts have been developed in the attempt to identify subjects at high risk of mortality. In this study, elevated admission BUN level was found to be a predictor of all-cause in-hospital mortality. BUN testing is commonly part of the basic metabolic panel; and it can be used to detect high-risk patients with APE, and it bears little risk, is inexpensive, and easy to perform.

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